Research Article

Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study

Number: 1 September 8, 2026

Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study

Abstract

Objective: This study aimed to evaluate the forensic outcomes of medical leave reports and to examine the relationship between board decisions and factors such as report duration, diagnosis-report consistency, medical documentation, treatment consistency, and guideline-duration compatibility. 
Methods: This retrospective analytical study included medico-legal files submitted to the 7th Specialization Board of the Council of Forensic Medicine between 2019 and 2024 for expert evaluation of the scientific appropriateness of medical leave reports. Therefore, the study population represents selected disputed or questioned cases rather than routine medical leave reports. After excluding cases with missing data, 99 cases were analyzed. Board decisions were classified as “appropriate/partially appropriate” or “not appropriate.” Statistical analyses included the Mann-Whitney U test, chi-square test, and binary logistic regression. The logistic regression model was fitted using the Enter method, and the variables entered into the model were explicitly reported. Because guideline-duration compatibility showed complete separation, Firth penalized logistic regression was applied as an additional sensitivity analysis.
Results:  Of the cases, 59.6% were female (n=59) and 40.4% were male (n=40). The median report duration was 20 days (IQR: 8.5-30.0). Overall, 83.8% of reports were considered not scientifically appropriate, 15.2% appropriate, and 1.0% partially appropriate. The most common reasons were mismatch between diagnosis and leave duration (53.5%) and insufficient medical evidence (41.4%). Report duration was significantly longer in the not appropriate group. Board decisions were significantly associated with report duration, diagnosis-report consistency, medical documentation, treatment consistency, guideline compatibility, age group, and report type (p<0.050). In multivariable analysis, longer report duration was associated with higher odds of a “not appropriate” decision. In the Firth penalized regression model, lack of consistency with the treatment process was also associated with the outcome; however, the estimate was unstable and imprecise, and should therefore be interpreted cautiously.
Conclusion: Report duration, diagnosis-report consistency, medical documentation, treatment consistency, and guideline compatibility were associated with board decisions in this selected medico-legal sample. These findings should be interpreted within the context of selected disputed cases referred for forensic evaluation and should not be generalized to all routine medical leave reports.

Keywords

Medical Leave, Sickness Absence, Medical Documentation, Guideline Adherence, Logistic Regression

Supporting Institution

The authors declare that this study received no financial support.

Ethical Statement

The study protocol was approved by the Scientific Research Committee of Council of Forensic Medicine (approval number: 21589509/2025/1491, date: 11.11.2025).

Thanks

The authors declare that there are no acknowledgements for this study.

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APA
Beşkoç, C., & Aslıyüksek, H. (2026). Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study. Turkish Journal of Public Health, 1. https://doi.org/10.20518/tjph.1904960
AMA
1.Beşkoç C, Aslıyüksek H. Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study. TJPH. 2026;(1). doi:10.20518/tjph.1904960
Chicago
Beşkoç, Caner, and Hızır Aslıyüksek. 2026. “Forensic Evaluation of the Appropriateness of Medical Leave Reports: A Retrospective Analytical Study”. Turkish Journal of Public Health, no. 1. https://doi.org/10.20518/tjph.1904960.
EndNote
Beşkoç C, Aslıyüksek H (September 1, 2026) Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study. Turkish Journal of Public Health 1
IEEE
[1]C. Beşkoç and H. Aslıyüksek, “Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study”, TJPH, no. 1, Sept. 2026, doi: 10.20518/tjph.1904960.
ISNAD
Beşkoç, Caner - Aslıyüksek, Hızır. “Forensic Evaluation of the Appropriateness of Medical Leave Reports: A Retrospective Analytical Study”. Turkish Journal of Public Health. 1 (September 1, 2026). https://doi.org/10.20518/tjph.1904960.
JAMA
1.Beşkoç C, Aslıyüksek H. Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study. TJPH. 2026. doi:10.20518/tjph.1904960.
MLA
Beşkoç, Caner, and Hızır Aslıyüksek. “Forensic Evaluation of the Appropriateness of Medical Leave Reports: A Retrospective Analytical Study”. Turkish Journal of Public Health, no. 1, Sept. 2026, doi:10.20518/tjph.1904960.
Vancouver
1.Caner Beşkoç, Hızır Aslıyüksek. Forensic evaluation of the appropriateness of medical leave reports: A retrospective analytical study. TJPH. 2026 Sep. 1;(1). doi:10.20518/tjph.1904960